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Many people don’t yet realize what having an advance directive means to them or why it is important to make sure one is in place prior to giving consent for medical treatment. Patients have the right to make decisions about the medical care they are about to receive. They also have the right to be informed of the treatment options available prior to receiving said medical care.
Many people prefer to choose ahead of time the kind of treatment they want to keep them alive. Advance directive documents ensure their wishes are known in advance. The Patient Self-Determination Act of 1990 requires agencies to
- provide patients with written information describing their right to make decisions about their medical care
- ensure their written wishes are placed in a prominent location in their medical record and all staff is informed
- comply with requirements of State law and court decisions regarding advance directives
- provide care to the patient whether they have an advance directive or not.
Who is eligible to have an advance directive?
Any “competent” adult has the right to accept or refuse treatment. Competent means the patient has the ability to understand their medical condition and the medical treatment health care providers are recommending. They need to be able to weigh the possible benefits or risks involved in that treatment and make the decision whether or not to accept the treatment.
As long as patients are competent, they are the only one who can decide what kind of treatment they will accept or reject. They are the only one who can say yes or no to medical treatment. They can even choose to say no to treatment that would keep them alive longer and others, such as family members, friends and health care providers, want them to have the medical treatment.
What happens if the patient is unable to make the decision?
If patients are unable to make their own decisions about their medical care, others will need to make those decisions for them. If the patient has not left prior instructions regarding the medical care their family or the courts will need to make those decisions for them.
Unfortunately, their family or the courts may not make the same decisions the patient would in a particular situation. For example,
- What would you decide if you were unconscious and not likely to wake up no matter what?
- If you knew you were going to die soon no matter what, would you refuse or accept medical intervention?
- Would you want the treatment others might decide you should have?
These are important questions people need to address prior to medical intervention and treatment. Families have had deep discussions and disagreements about the medical treatment their loved one needs, in their opinion. If the patient is involved in those discussions, whose side would they choose, if any?
The patient alone, if competent, should choose the course of treatment he or she will accept.
Make sure that you have an advance directive signed and available for health care providers in case of an emergency. In our case, an advance directive for my father is on file at our local hospital, with a copy kept at home.
